Thursday, October 20, 2016

Peri-op Clonidine: Benefits Not There, But Hypotension Is

Anesthesiologists who use perioperative clonidine in the hope of
reducing acute postoperative pain or opioid consumption need to
reconsider their efforts.

According to a randomized controlled
trial at the Cleveland Clinic, in Ohio—the largest such trial
ever—researchers found that the drug has neither of these perceived
benefits, and its use may come at the expense of hypotension.

“Anesthesiologists
have been using clonidine for sedation and analgesia for years, even
though it’s primarily a blood pressure medication,” said Alparslan
Turan, MD, professor of anesthesiology and vice chair of the Department
of Outcomes Research at the Cleveland Clinic. “However, the only place
where it’s been proven to work is in epidural and caudal analgesia. Oral
and transdermal use have not been tested in large trials, and the data
in the literature is not that solid.”